Measuring measures: introducing performance measurement in the Dutch health care sector

Abstract

The Dutch government has sought to increase transparency in the performance of medical institutions. For hospitals this has presented three challenges for performance measures, each related to gaining authority and support from all those (public and private) bodies already involved in quality assurance. The experience raises issues about the speed of implementation, scope, burden and impact on hospital image of performance measurement regimes. It also suggests a tension between market-based and other mechanisms used to ensure quality.